Kim Han Kyeol, Lee Yoon Suk, Jung Woo Jin, Cha Yong Sung, Cha Kyoung-Chul, Kim Hyun, Lee Kang Hyun, Hwang Sung Oh, Kim Oh Hyun
Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
J Trauma Inj. 2023 Mar;36(1):22-31. doi: 10.20408/jti.2022.0049. Epub 2022 Dec 6.
Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI.
The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study.
On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center.
The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.
创伤性脑损伤（TBI）直接影响患者的生存，并可导致长期后遗症。我们研究的目的是调查在一家单一的三级综合医院设立创伤中心是否改善了TBI患者的急诊护理和临床结局。
本研究的参与者为2012年3月1日至2020年2月28日期间前往我们的一级创伤中心就诊的所有TBI患者、单纯TBI患者以及在24小时内接受手术的TBI患者。患者分为两组：创伤中心运营前后就诊的患者。进行了对比分析。本研究调查了详细急诊护理时间、住院时间和临床结局的差异。
通过将整个TBI患者群体分为上述两组进行比较，发现在创伤中心运营后就诊的患者组中有以下结果：功能预后良好的患者数量增加（分别为P<0.001和P=0.002），存活出院的患者数量增加（分别为P<0.001和P<0.001），总体急诊护理时间缩短（所有项目值均为P<0.05）。然而，创伤中心运营前后就诊的TBI患者在重症监护病房住院时间、呼吸机使用天数和总住院时间方面没有显著差异。
研究结果证实，通过在三级综合医院设立创伤中心，总体TBI患者和单纯脑损伤患者的治疗效果和急诊护理得到了改善。
